By Dan Hounsell, Senior Editor

Workplace violence is a pervasive and growing threat to healthcare workers in hospitals and other medical facilities. It harms workers and increases anxiety, depression and staff turnover. It also adversely affects patient safety. 

Rates of workplace violence are likely underestimated because past studies have mostly used surveys that rely on recall of past events. A recent study in The Joint Commission Journal on Quality and Patient Safety overcomes this barrier by more precisely measuring nurse and patient care assistant exposure rates to patient aggression in real time, shedding light on prevention and management measures. 

The research team examined the incidence of patient and visitor aggressive events toward patient care staff on five inpatient medical units in a community hospital and an academic hospital setting. Data was collected using aggressive incident and management logs and demographic forms over 14 days. 

Related: Workplace Violence: Finding Effective Training

A total of 179 aggressive events were recorded, resulting in a rate of 2.54 aggressive events per 20 patient days. Patient verbal aggression rates — 2.00 events per 20 patient days or two events daily on a 20-patient bed inpatient unit — were higher compared to physical aggression rates — 0.85 events per 20 patient-days. The staff aggression exposure rate was 1.17 events per 40 hours worked. 

The most common precipitants of workplace violence included: medication administration, 18.6 percent; waiting for care, 17.2 percent; and delivering food and drinks, 15.9 percent. Most aggressive events occurred during the day shift, whereas evening or night shift aggressive events were fewer in comparison at 24.3 percent and 25 percent, respectively. Also, 75.2 percent of events were managed with verbal de-escalation as the only intervention. 

Dan Hounsell is senior editor for the facilities market. He has more than 30 years of experience writing about facilities maintenance, engineering and management.